What it takes to take away
Iwas lifting weights at the gym last week when I noticed the facility’s petite trainer (who I refer to mentally as The Boss) working with a new client. She takes on new people all the time, but this client was different. He towered over her by at least a foot—he was too large for some of the fitness machines— and he might have outweighed her by a factor of three or four.
It must be tough for her to take on a client like him, I thought. He didn’t get in his current physical condition overnight, and even with her professional guidance, he won’t be able to transform himself all that quickly.
No matter what the motivation and determination, researchers report on Healthline.com the overall chances of an obese man ever obtaining a “normal body weight” are 1 in 210. For women, it’s 1 in 124. Those odds worsen as a person’s weight increases; men with a body mass index over 40 have a 1 in 1,290 chance of recovering a healthy weight, while women in that category have a 1 in 677 chance.
We can argue about what a “normal” body weight is; the point is that after you’ve crossed a certain threshold, it’s difficult to get back to whatever you consider your fighting weight. But the guy in the gym has taken the first, most important and maybe hardest step; you don’t achieve anything without trying.
I know this. I’ve been (unhealthily) obsessed with my body weight for years. I recall a time while in college when I weighed 50 pounds more than I do now. After friends and family started commenting unfavorably on my appearance (even my mother became concerned), I had a serious talk with myself that resulted in an effort to remedy the situation with a regimen of will power based on dieting and exercise.
I went on a brutally low-fat and low-sugar food intake program, limiting myself to 1,000 calories or less a day (writing down everything I ate, along with each serving’s caloric content, which takes up a lot of time). That worked pretty well for a while until my body seemed to figure out that it had to make do with less food, and the weight loss stalled.
Then I ran across a doctor specializing in weight loss in a nearby town who was in the business of prescribing “diet pills”—a month’s supply was $10. I was puzzled during my first visits that many others in the facility’s bare-bones waiting room obviously were anything but overweight.
No wonder; we were all ingesting daily doses of amphetamines—dexedrine, known to those of us using them as green and clears. The capsules not only suppressed appetite, but also worked as an antidepressant. That explained why there were so many twitchy, slender, chatty patients in the waiting room.
Too bad the drugs had high dependence and abuse potential. It got to the point that I couldn’t have a good time doing anything without using dexedrine. Eventually I weaned myself from it (and the weight-loss specialist mysteriously disappeared from the landscape), transferring my weight-loss passion to an over-abundance of exercise (two or three hours a day involving a mix of running, swimming, bicycling, weight training, yoga, and Pilates) and increased dedication to maintaining a healthy weight.
It worked, and continues to work. But I’m stuck with a life-long dependence on artificial sweeteners and an irrational terror of eating anything high in calories and fat.
Now there are new-generation drugs such as Wegovy that are effective for weight loss. According to UCDavis Health, a weekly injection works by mimicking a naturally occurring hormone—as those hormone levels rise, the molecules go to your brain, telling it you’ve had enough to eat. It also slows digestion by increasing the time it takes for food to leave the body, similar to the effect of bariatric surgery.
Using this drug can lead to the body establishing a new normal (as my college-age body did with dieting and exercise) and causing weight to plateau, which can lead to gaining back much of what was lost within five years.
A weekly dose of Wegovy, an FDA-approved weight loss medication, is around $270, which, even allowing for inflation, far exceeds the $10/monthly price for green and clears. Several insurance plans, including Blue Cross Blue Shield, Aetna, Cigna, and UnitedHealthcare, cover Wegovy.
Despite these challenges, using Wegovy is easier than following a disciplined diet and excessive exercising, and can provide the instant gratification that we’ve become accustomed to in our it’s-all-about-me culture. Other than figuring out what to do with that pricey, attractively downsized new wardrobe that’s been accumulated, who cares what happens down the line? We want what we want.
I will be interested to see what the outcome will be for my fitness trainer’s currently well-intentioned new client. As in life, around 80 percent of working out is showing up and moving around. There’s no guarantee of success, but if you don’t do it, it doesn’t get done.
It’s not an easy road to travel; the terrain changes all the time. Someday, maybe science will give us a magic pill. Until then, and even after then, I’ll be in the gym.